BMC primary care最新文献

{"title":"Primary care practices' choice of implementation strategy for continuous glucose monitoring for patients with diabetes: a multiple methods study within a larger hybrid type-3 effectiveness-implementation study.","authors":"Kimberly T Wiggins, Tristen L Hall, Bonnie Jortberg, W Perry Dickinson, L Miriam Dickinson, Jessica A Parascando, Douglas H Fernald, Chelsea Sobczak, Sean M Oser, Tamara K Oser","doi":"10.1186/s12875-025-02903-0","DOIUrl":"10.1186/s12875-025-02903-0","url":null,"abstract":"<p><strong>Background: </strong>Most diabetes care occurs in primary care. Continuous glucose monitoring (CGM) is associated with clinical, behavioral, and psychosocial benefits. While CGM uptake in primary care is increasing, understanding models to support CGM use in diverse primary care practices is needed. The PREPARE 4 CGM study evaluated strategies to implement CGM in primary care. We compared characteristics among practices choosing a practice-led, self-paced CGM implementation strategy or referral to a virtual CGM implementation service that provided patients and their referring primary care practices CGM initiation and data interpretation support for at least six months.</p><p><strong>Methods: </strong>Colorado PC practices interested in implementing CGM enrolled and chose to use the American Academy of Family Physicians Transformation in Practice Series (TIPS): CGM implementation modules or refer patients to a virtual CGM initiation and education service designed and staffed by a primary care multi-disciplinary team. In this multiple methods study, baseline practice characteristics were compared across study arms using chi-square and t-tests. Semi-structured interviews with practice members provided additional context to explain study arm selection.</p><p><strong>Results: </strong>Of 76 practices enrolled, 46 chose self-paced implementation using TIPS modules, 16 of which (35%) had a diabetes care and education specialist (DCES) in the practice; of the 30 that chose the virtual CGM initiation service, none (0%) had a DCES, X²(1, N = 62) = 11.046, p <.001. Aside from having a DCES, no differences in 37 other practice characteristics were seen between groups.</p><p><strong>Conclusions: </strong>Primary care practices were eager to implement CGM. All practices with a DCES chose to implement CGM on their own; of the practices without a DCES, implementation method selection was evenly split (half chose to implement on their own, half chose virCIS). DCESs may have potential as diabetes technology champions in primary care practices. Referral to the virtual CGM implementation service allowed access to a certified DCES and multidisciplinary team for practices without them. As many practices without a DCES also chose to implement CGM on their own, multiple models may be necessary to foster CGM implementation in primary care.</p><p><strong>Trial registration: </strong>This project was reviewed and approved by the Colorado Multiple Institutional Review Board (COMIRB; Protocol 21-4269) and registered with ClinicalTrials.gov on March 23, 2022 (NCT05336214).</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"195"},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking the chains in plato's cave: acute care in general practice.","authors":"Johannes Rieken, Daniel Hötker, Christoph Strumann, Thomas Kötter, Jost Steinhäuser","doi":"10.1186/s12875-025-02901-2","DOIUrl":"10.1186/s12875-025-02901-2","url":null,"abstract":"<p><strong>Background: </strong>It is known that Emergency Departments (EDs) handle lower patient loads during periods when general practitioners (GPs) are on service. However, the acute cases managed by GPs are not well described yet.</p><p><strong>Objective: </strong>This study aims to assess acute medical cases presented at GP's offices.</p><p><strong>Methods: </strong>Medical students documented urgent medical cases as defined by patients during a practice internship in GP practices in Northern Germany, from February to July 2024. Levels of urgency were defined as \"not-acute\" (could have been treated on another day), \"acute\" (had to be treated the same day) and \"emergency\" (had to be treated immediately). Additionally, patient's concerns and expectations were written down and analyzed using qualitative content analyses.</p><p><strong>Results: </strong>A total of 523 cases were collected from 53 practices. The majority of cases (82%) were treated solely within the practice. Regarding levels of urgency, 275 (53%) were graded acute, 170 (33%) were not-acute and 70 (13%) cases were graded emergencies. Patients' motivations for urgently visiting their GP are rooted in fears, motivated by relatives, psychological issues and pain. Expectations range from reassurance to diagnostic examinations to the issuing of a sick leave.</p><p><strong>Discussion: </strong>GPs play a critical role in managing acute medical cases. The holistic approach of GPs including strategies to cope with uncertainty might be useful to be expanded to more specialties of medicine in the acute care sector.</p><p><strong>Conclusion: </strong>Motivations and expectations of a visit to a GP practice were diverse but comprehensible. An additional way to address the fears and uncertainties that send patients to the doctor could be through telemedicine offerings and educational initiatives, potentially starting as early as school age.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"198"},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' and clinicians' experiences of DIALOG+ in primary health care in Bosnia and Herzegovina: a qualitative interview study using thematic analysis.","authors":"Nejra Selak, Hana Sikira, Meliha Kiseljaković, Francois van Loggerenberg, Stefan Priebe, Alma Džubur Kulenović","doi":"10.1186/s12875-025-02845-7","DOIUrl":"10.1186/s12875-025-02845-7","url":null,"abstract":"<p><strong>Background: </strong>DIALOG + is a low-cost intervention proven to improve the subjective quality of life in patients with psychosis and anxiety disorders in low- and middle-income countries. In a recent study, DIALOG + was shown to be feasible for patients in primary care settings with long-term physical conditions and to result in an improvement in patient outcomes. The aim of this qualitative study was to explore the experiences of patients and clinicians using DIALOG + in Bosnia and Herzegovina to gain a better understanding of its impact in this setting.</p><p><strong>Methods: </strong>In-depth semi-structured interviews were conducted with 11 patients and 4 physicians, as well as two focus groups with 5 patients in each, all of whom participated in the intervention. Specific life and treatment domains discussed during the sessions between patients and clinicians were also analysed to determine which domains were most frequently addressed and where patients needed the most support. The interviews were audio-recorded, transcribed, and analysed using thematic analysis.</p><p><strong>Results: </strong>Four qualitative themes were identified: (1) DIALOG + structure and solution-oriented approach are helpful; (2) DIALOG + allows space for conversation; (3) Therapeutic relationship is improved, and (4) The intervention has its limitations.</p><p><strong>Conclusions: </strong>DIALOG + is a novel primary care intervention with positive effects on patients' lives, which enhance primary care. Nevertheless, it presents a new challenge in this setting. It is necessary to make adjustments in primary care, such as providing clinicians with more extensive training and ongoing support, as well as providing more time for the intervention's implementation.</p><p><strong>Trial registration: </strong>Study was registered prospectively within the ISRCTN Registry: ISRCTN17003451, 02/12/2020.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"194"},"PeriodicalIF":2.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the RE-AIM framework to evaluate the impact of shared medical appointments for diabetes mellitus: a systematic review and meta-analysis.","authors":"Wei Yang, Run Mao, Ziyun Liang, Zihui Liang, Ruixin Wang, Jiamin Wang, Xufei Luo, Meng Lyu, Dong Roman Xu, Yiyuan Cai","doi":"10.1186/s12875-025-02875-1","DOIUrl":"10.1186/s12875-025-02875-1","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a major global health concern. However, with proper treatment and management, individuals can lead healthy and fulfilling lives. Shared medical appointment (SMA), an integrated health service, effectively improves the clinical and behavioral outcomes of people living with diabetes (PLWD). Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this review aimed to evaluate the impact of SMA on PLWD treatment and management to inform the feasibility, sustainability, scalability, and equity of future SMA implementation.</p><p><strong>Methods: </strong>Eight electronic databases were searched for randomized controlled trials, non-randomized grouped controlled trials, pre/post studies, and interrupted time series model studies published in English and Chinese until February 2024. The information extraction was guided by the framework for outcome evaluation in implementation science, the RE-AIM framework. We performed meta-analyses for all randomized controlled trials (RCTs) using a random-effects model and presented Forrest plots and test statistics (Cochran's Q and I²) for heterogeneity analysis. Other results that did not lend themselves to quantitative analysis were summarized qualitatively.</p><p><strong>Results: </strong>Forty-seven studies were included in the review. The studies were evaluated according to the RE-AIM framework, and most studies reported effectiveness well, while all other dimensions were poorly reported. Most studies demonstrated that SMA effectively improved patients' Hemoglobin A1c (HbA1c) and Systolic Blood Pressure (SBP) levels and reduced healthcare costs. However, the SMA was a highly resource-demanded and complex intervention package.</p><p><strong>Discussion: </strong>The available evidence suggests that the SMA was beneficial in improving PLWD management and health outcomes among PLWD. However, its complexity would constrain its feasibility and scalability. Future research should assess the effect size of each intervention component and evaluate the implementation process, costs, and maintenance of SMA intervention, especially in resource-limited settings, to improve its sustainability, scalability, and equity.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"192"},"PeriodicalIF":2.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the work-life balance of Australian orthopaedic surgeons.","authors":"Wadad Kathy Tannous, Kingsley Agho, Moin Uddin Ahmed, David R J Gill, Michael Johnson","doi":"10.1186/s12875-025-02880-4","DOIUrl":"10.1186/s12875-025-02880-4","url":null,"abstract":"<p><strong>Background: </strong>Work-life balance (WLB) and preference for work location among Australian orthopaedic surgeons have been a focal point of research and policy discussions in Australia. This study, therefore, aimed to investigate the factors influencing work-life balance among Australian orthopaedic surgeons, and to develop strategies to improve their health and well-being.</p><p><strong>Methods: </strong>An online survey of 288 Australian Orthopaedic Association (AOA) orthopaedic surgeons was conducted, with data collected during October and November 2021 and was weighted to reduce gender bias. Based on the survey question \"What is the main factor that has influenced your choice in your current working location/employment?\" three binary outcome variables were considered: (1) work-life balance (WLB), (2) capacity to undertake the surgeons' preferred area of practice in orthopaedic surgery, and (3) availability of a public appointment and/or achieving a desired private/public mix (public job). Outcome variables were analysed using bivariate and multiple survey logistic regression after adjusting for sampling weights and potential confounding factors.</p><p><strong>Results: </strong>The prevalence of WLB was 16% (95% confidence interval (CI): 12.2-20.7), whereas the prevalence of capacity to undertake the surgeons' preferred area of practice in orthopaedic surgery was 33% (95%CI: 27.8-38.7), and the availability of a public appointment or the desired mix of private and public work was reported at 24.3% (95%CI: 19.7-29.6). Multivariate analyses revealed that WLB was the most commonly selected reason for practice location among outer metropolitan/regional orthopaedic surgeons. Primary decision-making factors varied based on training location, amount of work conducted in the public sector, and state. Surgeon age, gender, and being trained overseas were not related to practice location choice.</p><p><strong>Conclusions: </strong>Our research indicates that maintaining a healthy work-life balance would allow orthopaedic surgeons in inner regional Australia to work in any location. The growing and accepted use of telehealth, supported by government funding, will be demonstrated on the location of practice by orthopaedic surgeons and other clinicians.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"191"},"PeriodicalIF":2.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Specialist Teams for Older Persons (CST-OP) at risk of, or living with frailty in Ireland: a prospective cohort study of a new model of integrated care for community dwelling older adults.","authors":"Christina Hayes, Aoife Whiston, Christine Fitzgerald, Collette Devlin, Brian Condon, Molly Manning, Aoife Leahy, Katie Robinson, Rose Galvin","doi":"10.1186/s12875-025-02895-x","DOIUrl":"10.1186/s12875-025-02895-x","url":null,"abstract":"<p><strong>Background: </strong>This study explored the clinical and process outcomes of older adults at risk of or living with frailty who received an interdisciplinary Comprehensive Geriatric Assessment (CGA) in the community.</p><p><strong>Methods: </strong>This prospective cohort study recruited older adults aged ≥ 75 who were screened for frailty and referred to one of three CST-OP hubs in the Mid-West of Ireland by their GP. Follow-up assessments were conducted via telephone by an independent assessor at 30- and 180-days. The primary outcome was functional status. Secondary outcomes included primary healthcare use, secondary healthcare use, nursing home admission, health-related quality of life (HRQoL), patient satisfaction and mortality.</p><p><strong>Results: </strong>A total of 303 participants (mean age = 83.2 years) were recruited. Incidence of 30- and 180-day functional decline was 26.4% and 33.7% respectively. The majority of older adults who availed of community-based CGA maintained functional independence up to 6-months post index visit. At 30-days, the mortality rate was 1.0%, Emergency Department (ED) presentation 6.9%, hospitalisation 6.6% and nursing home admission 4.0%. HRQoL significantly improved at 30- and 180-days. There was a significant improvement in HRQoL, F(2,542) = 13.8, p < 0.001, η² = 0.5. The presence of frailty was a significant predictor of adverse outcomes.</p><p><strong>Conclusion: </strong>Community-based CGA results in favorable health outcomes including HRQoL among community-dwelling older adults. Community-based CGA may also mitigate against potentially avoidable ED presentations and hospitalisations. Use of the Clinical Frailty Scale is recommended to predict the risk of functional decline, increased rates of mortality, NH admission, hospitalisation or ED presentation at 30- and 180-days among community-dwelling older adults.</p><p><strong>Trial registration: </strong>The study protocol was prospectively registered on Clinicaltrials.gov (NCT05527223). Registered January 09, 2022. https://clinicaltrials.gov ..</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"193"},"PeriodicalIF":2.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of deprescribing antidepressants in nursing home residents with dementia-a cluster randomized controlled trial.","authors":"Pernille Hølmkjær, Maarten Pieter Rozing, Gritt Overbeck, Volkert Siersma, Anne Holm","doi":"10.1186/s12875-025-02894-y","DOIUrl":"10.1186/s12875-025-02894-y","url":null,"abstract":"<p><strong>Background: </strong>Older nursing home residents with dementia are commonly prescribed antidepressants despite limited evidence of clinical effect and a high risk of side effects. Deprescribing can be challenging and is often not attempted. The aim of the study is to investigate the effect of a multifaceted intervention targeting nursing home general practitioners and their collaboration with the nursing home staff on the reduction of antidepressant medication in older nursing home residents with dementia.</p><p><strong>Method: </strong>The study is a cluster-randomized, non-blinded, controlled trial. General practitioners working as nursing home physicians in the Capital Region of Denmark were recruited between June 1 and October 1, 2021. Eligible participants were individuals with dementia (diagnosed or suspected), ≥ 72 years old, receiving one or more antidepressants, and living in a nursing home with the associated nursing home physician. The complex intervention consisted of three main parts: 1) a training session occurring in the nursing home, 2) a pre-visit reflection tool, and 3) a dialog tool used during a structured home visit at the nursing home. The control group received enhanced care as usual. Primary outcome was the reduction of the total defined daily dose of antidepressants from pre- to post-intervention in the intervention group, compared to the control group. Secondary outcomes included mortality, changes in other psychotropic medication, hospitalization, and symptoms changes.</p><p><strong>Results: </strong>We recruited 21 clusters with 128 eligible participants (62/66 in intervention and control). Four clusters withdrew. Most participants were women, and the median age was 85. They received an average of nine different drugs, and the most commonly prescribed antidepressants were sertraline and mirtazapine. The OR for the reduction of antidepressants in the intervention group versus control was 2.3 (95% CI = 0.84-6.2). Mortality rates were similar between groups.</p><p><strong>Conclusions: </strong>The intervention did not significantly reduce antidepressant use among older nursing home residents with dementia. Further optimization and testing in a larger study are needed.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID NCT04985305, registration date: 2021-08-02.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"190"},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of suboptimal blood pressure, glycemic control, and associated factors among patients with diabetes and hypertension in primary health care facilities in Ghana: a multicenter retrospective cross-sectional study.","authors":"Thomas Hinneh, Bernard Mensah, Oluwabunmi Ogungbe, Jonathan Bayuo, Emmanuel Timmy Donkoh, Yvonne Commodore-Mensah","doi":"10.1186/s12875-025-02775-4","DOIUrl":"10.1186/s12875-025-02775-4","url":null,"abstract":"<p><strong>Background: </strong>Hypertension and type 2 diabetes mellitus are major risk factors for cardiovascular disease and are common indications for adult in-patient admissions in Ghana. Primary health facility data on blood pressure (BP) and glycemic control are needed to model the impact of strategies to reduce the high burden of cardiovascular disease risk in Africa.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted at four primary healthcare facilities in Ghana, from January 2023 to December 2023. Glycemic control was defined as fasting blood glucose < 7.0 mm/L, and BP control as < 140/90 mmHg for patients with only hypertension and < 130/80 mm/Hg for those with diabetes or both, per the Ministry of Health standard treatment guideline. Multivariate logistic regression analyses were conducted to assess associations between patient or facility-level factors and BP and glycemic control.</p><p><strong>Results: </strong>Among the 1,503 adults, the mean age was 63 years (± 13.1). Participants were mostly females (1194; 79.4%) and had at least primary-level education (324; 32.7%). Most participants (866; 57.6%) had hypertension, less than half (506; 33.6%) had both hypertension and type 2 diabetes mellitus, and (131; 8.8%) had only type 2 diabetes mellitus. Median systolic blood pressure was 136.7 mmHg (IQR; 126.7 -149.7), and median diastolic blood pressure was 79.7 mmHg (IQR: (73.2-86.4), both higher in patients with hypertension and type 2 diabetes. Suboptimal BP and glycemic control were found in 58.3% (95% CI: 55.6-60.7%) and 72.6% (95% CI: 68.4-75.6%) of patients respectively. Complications affected 14.5% (n = 218) of patients, with peripheral neuropathy in 9.0%(n = 135) and 4.3% (n = 65) for retinopathy. In an adjusted multivariate analysis, education (AOR = 1.5, 95% CI: 1.1-2.0, p = 0.02), glycemic control status (AOR = 2.6, 95% CI: 2.0-3.5, P < 0.001) and facility ownership (AOR = 2.45, 95% CI: 1.91-3.101, p < 0.01) were associated with suboptimal BP control. For suboptimal glycemic control, associated factors included the presence of complications (AOR = 1.7, 95% CI: 1.0-2.9, p = 0.004), educational status (AOR = 1.9, 95% CI: 1.1-3.3, p = 0.01), and advanced age (> 60 years) (AOR = 1.5, 95% CI: 1.0-2.1, p = 0.04).</p><p><strong>Conclusions: </strong>The prevalence of suboptimal blood pressure and glycemic control was high for patients accessing primary level healthcare. Age, education, and complications were associated with suboptimal blood pressure and glycemic control. Strategies to reduce the high burden of suboptimal blood pressure and glycemic control should address patient- and facility-level factors to improve treatment outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"189"},"PeriodicalIF":2.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural capacity, self-efficacy, and humility of healthcare providers: a survey in Southeast Iran.","authors":"Shima Gadari, Somayeh Jouparinejad, Sara Noori Farsangi, Amirreza Sabzi, Aida Jafari, Jamileh Farokhzadian","doi":"10.1186/s12875-025-02898-8","DOIUrl":"10.1186/s12875-025-02898-8","url":null,"abstract":"<p><strong>Background: </strong>With the increasing cultural diversity in healthcare settings, it is essential for healthcare providers to possess the three key characteristics of cultural capacity, self-efficacy, and humility in order to deliver optimal and culturally congruent care. The present study aimed to assess the relationship between cultural capacity, self-efficacy, and humility among healthcare providers.</p><p><strong>Method: </strong>This cross-sectional study used a convenience sampling method to include 203 healthcare providers from comprehensive health centers and facilities affiliated with Kerman University of Medical Sciences in Kerman, southeastern Iran. Data were collected through a demographic information questionnaire, the Cultural Capacity Scale Arabic (CCS-A), the Cultural Self-Efficacy Scale (CSES), and the Foronda's Cultural Humility Scale.</p><p><strong>Results: </strong>The results indicated that healthcare providers exhibited a moderate level of cultural capacity (60.38 ± 19.12) and cultural self-efficacy (60.29 ± 19.39), and occasionally demonstrated cultural humility (60.22 ± 11.43). Furthermore, cultural capacity showed a direct and significant correlation with both self-efficacy and cultural humility (P < 0.001). Additionally, cultural humility exhibited a direct and significant correlation with cultural self-efficacy (P < 0.001). Academic degree (β = 0.13, p = 0.005), education outside of place of residence (β = 0.1, p = 0.02), attendance in cultural care training (β = 0.21, p = 0.01), self-efficacy (β = 0.56, p = 0.001), and cultural humility (β = 0.11, p = 0.001) were significant predictors of the cultural capacity.</p><p><strong>Conclusion: </strong>The results suggested that the cultural capacity, self-efficacy, and humility of healthcare providers were at a moderate level, and these variables were interrelated. Given that cultural capacity, competence, and humility are fundamental concepts in addressing ethnic and cultural diversity in societies, healthcare policymakers should strive to improve the levels of these important cultural attributes and develop strategies to enhance these qualities in healthcare providers.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"188"},"PeriodicalIF":2.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in dementia screening outcomes: the influence of primary care providers' occupations and knowledge, attitudes, skills.","authors":"Yanglin Qiu, Xinyu Fan, Yanjuan Wu, Shibin Wang, Wenyan Tan, Jing Liao","doi":"10.1186/s12875-025-02886-y","DOIUrl":"10.1186/s12875-025-02886-y","url":null,"abstract":"<p><strong>Background: </strong>Dementia is a growing concern in China. Primary care screening is proposed as a timely and cost-effective way to identify potential cases, while its implementation relies on primary care providers' (PCPs') knowledge, attitudes, and skills. Our study aimed to investigate whether dementia screening outcomes vary according to the PCPs' occupations and how PCPs' knowledge, attitudes, and skills are associated with screening outcomes.</p><p><strong>Methods: </strong>A two-stage dementia screening of residents aged 65 years and over in Guangdong, China was conducted using multistage cluster sampling. 252 PCPs, who completed questionnaires, were included in the analysis, along with 2823 older adults screened by them. Screening outcomes included the positive rate of screening, and positive predictive value (PPV). PCPs' knowledge was assessed by the Dementia Knowledge Assessment Scale, attitudes by the Dementia Care Attitudes Scale, and skills by a validated self-designed questionnaire. Multilevel logistic regression was used to assess the associations of PCPs' occupations, knowledge, attitudes, and skills with dementia screening outcomes.</p><p><strong>Results: </strong>Knowledge scores in dementia care differed significantly (P = 0.005) among PCPs of different occupations, while attitudes and skills did not. The positive screening rate had no significant association with PCPs' occupations. Public health physicians (OR = 2.927, 95%CI: 1.091-7.854) and nurses (OR = 3.712, 95%CI: 1.141-12.069) had a higher PPV than general practitioners (GPs). Higher dementia-care skills score (OR = 1.024, 95%CI: 1.004-1.046) was associated with a higher positive rate of screening. Positive attitudes towards dementia care was associated with a lower positive rate of screening (OR = 0.948, 95% CI: 0.905-0.994) and a higher PPV (OR = 1.114, 95% CI: 1.007-1.234).</p><p><strong>Conclusions: </strong>In community settings, involving different occupations of PCPs besides GPs in dementia screening and systematically promoting dementia-care skills training and positive attitudes towards dementia care are important to improve the effectiveness of dementia screening and management.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"187"},"PeriodicalIF":2.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}